Palliative care as an emerging role for respiratory health professionals: Findings from a cross-sectional, exploratory Canadian survey

Effect of end-of-life care education on perceived self-efficacy of the pediatric respiratory therapist

Background

End-of-life care (EoLC) is difficult for respiratory therapists (RTs), causing struggles with providing EoLC and grief during and after the death.

Objective

The objective of the study was to determine if EoLC education can increase RTs' perception of knowledge of EoLC, respiratory therapy as a valuable EoLC service, comfort providing EoLC, and knowledge of ways to deal with grief.

Methods

One hundred and thirty pediatric RTs completed a 1 h EoLC education session. Afterwards, a single-centre descriptive survey was administered to the 60 volunteers out of the 130 attendees. To determine RTs' self-rated change in knowledge of EoLC, perception of respiratory therapy as a valuable EoLC service, comfort with EoLC, and knowledge of ways to cope with grief. Statistical analysis included percent change.

Results

Overall, 96% of surveyed RTs agree they had an increase in knowledge, perception of RT services, comfort with providing care, and coping. Only 4% felt that this course had little benefit overall but still perceived value in RT EoLC and increased knowledge of long- and short-term ways to deal with grief.

Conclusion

Education on EoLC practices increased pediatric RTs' perception of knowledge, perceived value of respiratory therapy in EoLC, comfort with EoLC, and knowledge of coping resources.

A survey on the attitudinal differences between acute and community settings

INTRODUCTION

While challenges facing community and acute care practitioners have been studied elsewhere, this is not the case for respiratory therapists (RTs). This study aimed to examine attitudinal differences amongst RTs in British Columbia regarding challenges faced by acute and community settings.

METHODS

A 40-item anonymous online survey was sent to members of the British Columbia Society or Respiratory Therapists. Of the 40 questions, 11 were relevant to the study's aim.

RESULTS

Of 1024 invitations, 197 (19.2%) responded. One-hundred and seventeen (59.4%) self-identified as working in acute care settings, 53 (26.9%) in community settings, and 27 (13.7%) as "other". Stress- and interpersonal-related challenges showed statistically significant differences (P ≤ 0.05) based on work setting. Acute care had the highest percentage of responses for challenges related to technology, stress, inter-professional collaboration, and training. Community settings had the highest percentage in challenges related to independence and education. Both being equal received the highest percentage in challenges related to problem-solving, interpersonal, communication, and resource management.

DISCUSSION

While attitudinal differences exist, they are not extreme. It did not appear that respondents' primary motivation was to vote along "party lines".

CONCLUSIONS

The setting an RT works in can influence attitudes related to stress and interpersonal challenges. Despite this, one setting is not universally more challenging. Acute care settings can have greater technological, inter-professional, and training-related challenges. Community settings can have greater independence and education-related challenges. Both settings can provide similar challenges with problem-solving, communication, and resource management.

When should palliative care be introduced for people with progressive fibrotic interstitial lung disease? A meta-ethnography of the experiences of people with end-stage interstitial lung disease and their family carers

BACKGROUND

Little is currently known about the perspectives of people with interstitial lung disease and their carers in relation to the timing of palliative care conversations.

AIM

To establish patients' and carers' views on palliative care in interstitial lung disease and identify an optimum time to introduce the concept of palliative care.

DESIGN

Meta-ethnography of qualitative evidence. The review protocol was prospectively registered with PROSPERO (CRD42021243179).

DATA SOURCES

Five electronic healthcare databases were searched (Medline, Embase, CINAHL, Scopus and Web of Science) from 1st January 1996 to 31st March 2022. Studies were included that used qualitative methodology and included patients' or carers' perspectives on living with end-stage disease or palliative care. Quality was assessed using the Critical Appraisal Skills Programme checklist.

RESULTS

About 1779 articles were identified by initial searches. Twelve met the inclusion criteria, providing evidence from 266 individuals across five countries. Three stages were identified in the illness journey of a person with interstitial lung disease: (1) Information seeking, (2) Grief and adjustment, (3) Fear of the future. Palliative care involvement was believed to be most appropriate in the latter two stages and should be prompted by changes in patients' health such as respiratory infections, onset of new symptoms, hospital admission, decline in physical function and initiation of oxygen.

CONCLUSIONS

Patients and carers prefer referral to palliative care services to be prompted by changes in health status. Future research should focus on supporting timely recognition of changes in patients' health status and how to respond in a community setting.